Following our lunch, which was another example of how working in an American Fire House is so much more different to on a UK ambulance station, i.e. everyone sitting down together and enjoying a wonderful home cooked meal (with HUGE portions!). It really did feel like sitting down for lunch with a big family. Conversation was flowing, music was coming in from the TV in the lounge area when all of a sudden everything stopped and we all looked over at the screen…..What’s this? Was Justin on the TV already??
No, but it was one hell of a likeness. Whatever music channel was on, there was some 70’s style music on. Willa noticed that one of the singers on screen had a startling resemblance to Justin, which just had to be recorded for Prosperity. Justin and Willa jumped into action, and I got the shot! What do you think?
The only thing that would complete the picture was if Justin only had blonde hair. In comes Janet to the rescue to lend Justin some of her luscious long blond hair. And…….Hey Presto!!
The laughter died down and everyone moved on to washing dishes and cleaning up. I wasn’t allowed to help with the washing so busied myself with wiping down the table. Once that was done, I popped out to the garage to see Ted and Chris who were busy editing, emailing, tweeting and uploading videos. Those two guys really didn’t stop during the whole time we were out!
It wasn’t long before the tones went off again, and everyone stops to listen to hear if it is the Engine or the Ladder going out. This time it was neither, instead it was for the Rescue Captain to go and assist with an unconscious patient.
Off he went in his SUV. I hadn’t really had much of a chance to see what his role was and how he fitted into this whole Fire Fighter/Paramedic thing so far, but I would change that before I went home from the Shift.
A couple more Fire Calls came in, all of which were false alarms or malfunctions in the alarm systems, but at least I got another ride out in Engine 13!
Then we had another medical call. This time to a collapse in the foyer of an office building just around the corner. We all took our seats again, Chris joining us to film the action whilst Ted stayed behind to get some shots of Engine 13 leaving the Station. As we arrived, Justin and I got out first whilst the other members of the crew followed behind. I made it my goal to actually have some part of these calls so I ensured that I at least grabbed the defib to carry in (there, you see, I was actually useful to have around). As we approached the patient, who was still sitting in a chair, you could tell that it wasn’t just another ‘nuisance call’. The lady, in her early 50’s, was pale and looked like she was just staring out into space. Justin quickly checked her radial pulse and called out
With that he, grabbed the patient’s upper body and I grabbed her legs, thighs and waistband.
“1, 2, 3 Lift!”
As soon as she was on the floor, I just grabbed hold of her feet and hoisted them into the air so that they were resting on my waist whilst I was standing up. To be honest, I didn’t know if that was what I should have been doing, but sometimes you can’t help but go into automatic pilot. If someone is so hypotensive that they lose their radial pulse, then those legs just need to go up!
Whether I should have done it or not, Justin seemed happy with what I was doing. She came round after about 20 seconds and tried to get back up. Everyone around her, Justin, I and the other 3 crew members of Engine 13 all tried to get her down on the ground. She was confused and obviously in need of hospital. After maybe 2 minutes the SFFD Ambulance arrived and took over care of the patient. Justin tidied up and stowed everything away back on the Engine and went to finish off his handover to the Ambulance Crew, and I got the opportunity to get one of my favourite pictures of my trip :
I don’t know if he realised it then, but I’m sure he did after he came over to the UK. The job he is doing on Engine 13 as the Paramedic is exactly the same as I do on my Rapid Response Car. Go out, get there first, stabilise the patient and have a good assessment ready where possible for the arrival of the crew. Obviously the only default is to transport to hospital or get a refusal form signed, but the basic role of the Engine Paramedic is not too different from mine on the car.
It wasn’t until afterwards when we were discussing the case with Ted and Chris that Justin said how weird it was that I did that with the legs, as he was just about to ask someone to do it, but I had already done it by the time he looked up. Proof yet again….Same patient, different country, and remember the basics!
The afternoon was interspersed with various other medical and alarm calls, but also a fair amount of down time where we did some filming and discussion pieces. I had the opportunity to discuss my thoughts on Engine responses with Justin also.
My thoughts, after going out on a few medical calls, where based solely on what I had witnessed, and may not have been the norm. Maybe I was just lucky that it was a fairly quiet day and the SFFD and other agencies ambulances weren’t being stretched too much, but all I could think was that if there was already an ambulance in that response area that will meet whatever response time target is already there, and there is no expected need to have a large volume of staff on scene, then why does the engine have to respond at the same time as the Ambulance?
Surely that is putting a lot of people at risk, both SFFD staff and the public who are either on the roads or pavements (sorry, sidewalks!) for a negligible benefit. Now, I would understand completely when there is not an ambulance close by to respond, and in fact, that is what I would love to see brought in to my own area.
As if to bring this point home, just before the evening meal at Station 13, the tones went off and again, it was for the Rescue Captain. This time however, it came through as resuscitation so Justin quickly asked the Captain, if I could come along with him, to which he replied that I could.
So I squeezed into the back of his SUV and off we went. It was a much farther distance than the engine would cover as there are far less of the Rescue Captains than there are ambulances or Engines. They are Paramedics who do not work on the Fire Engines at all. Their purpose it to arrive on scene and act in a supervisory capacity to ensure that everything is being done correctly and to provide assistance if required with some interventions that only they are allowed to perform, such as I.O cannulation. As we were travelling to this scene, he informed me that there would be two engines and an Ambulance on scene, as the first engine had only an EMT on board and not a paramedic, therefore a second engine was dispatched which had a paramedic as part of the crew.
We arrived on scene and were quickly informed that it was actually a heroin overdose pt that had gone into respiratory arrest. Naloxone had already been given before we got there and the patient was starting to come round.
I took a moment and stepped back a couple of paces and just counted … 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11!! 11 Members of the San Francisco Fire Department for 1 Patient !!!! 4 from each Engine, 2 from the Ambulance and 1 rescue Captain (oh and one UK paramedic in a green uniform standing there with his mouth hanging open!)
I understand the need to get a paramedic on scene for a life threatening emergency, I really do, but do you really need that many people on scene? This seems like the perfect type of job for Justin to trial his Rapid Response Model…Same call comes in. Justin responds as a lone paramedic in a fast response car with an ambulance following close by. 2 Vehicles, 3 members of staff.
Now I know what you are thinking – if the patient is in arrest, we would need more people in the back. Yes I completely agree, and that is where the benefit lies with having so many staff on scene – you can always pinch one to come in the back. However, if Justin was there in his RR Car, then he could travel in the back of the vehicle and lock his vehicle until the crew can drop him off afterwards. To be truthful, I think we have just gotten used to being alone in the back of an ambulance and trying to do the best CPR that you can whilst giving repeated doses of cardiac drugs etc! That doesn’t make it right though. I can’t think of a single medic who would not want at least two people in the back of an ambulance for a serious ‘working job’
Anyway, it’s something to think about. How many staff is too many on scene?
Once the patient had been transferred to hospital from the scene (in restraints, which is another thing that could never happen in the UK, The Rescue Captain drove me back to the Station 13, just in time to have me evening meal.
Yet again, another fantastic meal. Which reminds me that I never did get hold of one of the ‘San Francisco Fire Departments Fire House Cook Books’ to bring home!
I filled my belly, offered to do the dishes again, but again to no avail, then pinched a lift back to my hotel from Ted.
It had been a great day. I had a lot of thoughts whizzing around in my head and had thoroughly enjoyed seeing the dual role that Justin delivers day in and day out of his working career.
I seemed to be getting a little bit starry eyed about life in San Francisco, you always think the grass is greener over on the other side, but in reality, I know that there are all of the frustrations I have over in the UK, over in San Francisco too.
We were meant to be doing another ambulance shift in the morning, but that had been lost due to some miscommunication down the line. We could have still worked a shift, but it would have been some ungodly hours which would have impacted hugely on our following day and also the one chance that Justin may get to actually get home early and spend some time with his good lady and his beautiful children.
It gave us the chance to meet up a little later than normal the next day (yeah, a little sleep in), and to go and get some filming done in some of the more scenic places around the bay, then actually have a little free time in the afternoon.
Sounded good to me………